Doffin, Jaclyn Elizabeth
Doffin, Jaclyn Elizabeth is an individual health care provider with primary practice located at 4750 Washington Sq , White Bear Lake MN 55110-3257. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Doffin, Jaclyn Elizabeth can be contacted via phone (651) 429-3379.Contact Information
Primary practice address
4750 Washington Sq
White Bear Lake MN 55110-3257
Phone: (651) 429-3379
Fax: (651) 429-8681
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2988 | Minnesota |
Profile Details
| NPI number | 1053360701 |
|---|---|
| LBN Legal business name | Doffin, Jaclyn Elizabeth |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 9th, 2006 |
| Last updated | May 21st, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053360701 | NPPES |
| Minnesota | Other | 132424 | UCARE |
| Minnesota | Other | 2202621 | UCARE |
| Minnesota | MEDICAID | 869675600 | UCARE |
| Minnesota | Other | HP46401 | UCARE |
| Minnesota | Other | 1011968 | UCARE |
| Minnesota | Other | 612R1ST | UCARE |
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